Finite Element Analysis of Thoracic Vertebral Stability Supported by the Fourth Spine

Abstract

Objective: In traumatic injuries of the thoracic spine, three variables are analyzed to make decisions: morphology of the injury, posterior ligamentous complex and neurological status; currently the fourth column is not evaluated; our objective was to determine the biomechanical behavior of the spine with a fracture of the fifth thoracic vertebral body when accompanied by a short oblique fracture of the sternum. Methods: An anonymous model of a healthy 25-year-old male was used, from which the thoracic spine and rib cage were obtained; in addition to the ligaments of the posterior complex and the intervertebral discs, four models were simulated. An axial section was made, a load of 400 N was applied, and the biomechanical behavior of each model was determined. Results: The area that suffered the most stress at the vertebral level was the posterior column of T4-T5 (tensile strength of 747 MPa), which exceeded the plastic limit, the load through the ribs was distributed from the first to the sixth (100 MPa), in the sternum the stress increased (200 MPa), the deformity increased to 45 mm. Conclusions: The sternum was a fundamental part of the spine’s stability; the combined injury severely increased the stress (8 MPa to 747 MPa) in the spine and exceeded the plastic limit, which generated an instability that is represented by the global deformity acquired (1 mm to 45 mm). Level of evidence II; Prospective comparative study.